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NURS 6630 Week 11 Final Exam Latest

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NURS 6630 Week 11 Final Exam Walden University

DNRS-6630-5/ NURS-6630N-5/ NURS-6630C-5/ NURS-6630F-5/ DNRS-6630F-5- Approaches to Treatment 2022

Question 1
What baseline levels should you perform before initiating an anti-ADHD medication?
Electrolytes, height, weight, white-blood cells
ECHO, heart rate, pulse
Height, weight, blood pressure, pulse
Blood pressure and pulse

Question 2
Which medication(s) requires a test dose to determine accurate use of the drug (i.e.,
how addicted the patient truly is on a certain drug) before beginning a titration schedule
to withdrawal the patient?
Butalbital
Lorazepam
Hydrocodone
A. I only
B. II only
C. III only
D. I and II

Question 3
Which of the following psychiatric conditions is present in both domains (i.e., core
psychopathology & pain-related psychological symptoms) of chronic pain that will likely
lead to an outcome of disability, pain, and poor quality of life?
A. Major depression
B. Personality disorder
C. Anger
D. Anxiety

Question 4
Which medication below would you use in addition to benzodiazepine treatment if the
patient is experiencing psychosis during alcohol withdrawal delirium?
Which medication below would you use in addition to benzodiazepine treatment if the
patient is experiencing psychosis during alcohol withdrawal delirium?
A. Naltrexone
B. Haloperidol
C. Propofol
D. Chlordiazepoxide

Question 5
If a patient suffers from a multitude of small strokes and later begins experiencing mood
disturbances in an acute fashion that sometimes resolve, from what type of dementia
would you think that patient may suffer?
A. Vascular Dementia
B. Frontotemporal Dementias
C. Alzheimer’s Disease
D. Dementia with Lewy Bodies

Question 6
If a patient is being managed for chronic pain and is not getting better after months of
therapy with multiple agents (i.e., NSAIDs with opioids, muscle relaxants with NSAIDs,
etc.), what should be your next step in helping the patient?
Add a high-dose opioid if patient is not already on the maximum dose.
Assess for a co-morbid psychiatric condition.
Tell the patient you have exhausted all your options and there is nothing more
you can do.
Refer the patient for a second opinion.
A. I and II
B. II and IV
C. III only
D. IV only

Question 7
T. C. is an 88-year-old male who is diagnosed at your clinic with Dementia with Lewy
Bodies. He currently has some debilitating gait issues, which makes his quality of life
very poor. His memory is still intact with minor deficits. Which medication would likely
benefit T. C. as his initial therapy?
A. Levodopa/carbidopa
B. Galantamine
C. Memantine
D. Benztropine
Of the axons involved in the transmission of pain, which one is thinly myelinated and
conducts that first feeling of pain that is often felt as coming on as a sharp, rapid
feeling?
A. ß-∆ fibers
B. A-∆ fibers
C. A-ß fibers
D. C fibers

Question 9
E. B., a 55-year-old female, is a patient at your clinic today who has a past medical
history significant for breast cancer, hypertension, hepatic cirrhosis, type 2 diabetes,
and a recent diagnosis of alcohol use disorder. She has no known drug allergies. She
states she is ready to quit drinking but fears the cravings that it may bring. Which
medication would you recommend for E. B. to begin?
A. Naltrexone
B. Acamprosate
C. Any benzodiazepine
D. Thiamine

Question 10
Which enzyme does disulfiram inhibit leading to a build-up of the ethanol metabolite
acetaldehyde?
A. Alcohol dehydrogenase
B. Microsomal ethanol oxidizing
enzyme
C. Aldehyde dehydrogenase
D. Aldehyde reductase

Question 11
Which of the following drugs in the treatment of Alzheimer’s Disease helps normalize
glutamate by antagonizing the NMDA receptor?
A. Memantine
B. Donepezil
C. Rivastigmine
D. Galantamine

Question 12
There are many different types of dementia. Which dementia is NOT a direct result of
disrupted neurotransmitters, but a result of degeneration of different regions in the
brain? Onset of the disease is typically before the age of 60, and very rare after the age
of 75.
A. Alzheimer’s Disease
B. Dementia with Lewy Bodies
C. Creutzfeldt-Jakob Disease
D. Frontotemporal Dementias

Question 13
Benzodiazepines can be withdrawn abruptly despite duration of therapy/abuse.
A. True
B. False
Question 14
What should our treatment goal be with our patients when it comes to managing chronic
pain?
A. The goal is to make the pain go completely away.
B. The goal is to make the patient feel numb so that the pain cannot be thought
about.
C. There are no specific treatment goals that we should discuss with our patients,
just so they don’t get their expectations too high.
D. The goal is to improve their function and to drop their pain scale to less than 5
out of 10.

Question 15
T. K. is a 72-year-old female who has suffered many strokes in the past, likely due to
uncontrolled hypertension and hyperlipidemia. She has now been diagnosed with
vascular dementia due to memory loss and motor system slowing. What is the
recommended treatment for T. K.?
A. T. K. needs the drug donepezil to help with her memory loss only.
B. T. K. needs the drug donepezil to help with her memory loss, but also needs
her hypertension and hyperlipidemia controlled.
C. T. K. needs the drug donepezil to help with her memory loss, but also needs
her hypertension controlled.
D. T. K. needs her hypertension controlled only.

Question 16
Of the following neurotransmitters, which ones play a critical role in modulating attention
in ADHD?
Dopamine
Epinephrine
GABA
Norepinephrine
Glutamate
A. II, III, and V
B. II and IV
C. I and IV
D. III only

Question 17
SSRIs can be used in alcohol use disorder and offer modest drinking reduction through
an anti-craving effect.
A. True
B. False

Question 18
Y. R. is a 35-year-old woman who presents to your clinic today complaining of ankle
pain. She said she was running the trail when she saw a snake. During a quick turn to
run away from the snake, she twisted her ankle. Which of the following medications may
be a good choice in helping Y. R. with her pain?
A. Oxycodone
B. Amitriptyline
C. Ibuprofen
D. Duloxetine

Question 19
Of the following medications, which one is contraindicated with stimulants such as
Ritalin or Adderall? (an MOA)
A. Atomoxetine
B. Clonidine
C. Amitriptyline
D. Phenelzine

Question 20
Which of the following drugs in the treatment of Alzheimer’s Disease requires
administration with food?
A. Memantine
B. Donepezil
C. Rivastigmine
D. Galantamine

Week 11 Final Exam Latest NURS 6630

Question 21
In the pathophysiology of Alzheimer’s Disease, there are certain proteins that lead to the
plaques and tangles that result in this progressive, irreversible brain disorder. Choose
the appropriate protein with its corresponding pathology.
Tau – tangles
Beta-amyloid – tangles
Tau – plaques
Beta-amyloid – plaques
A. I and II
B. II and III
C. II and IV
D. I and IV

Question 22
Which of the following drugs is often used in the management of opioid addiction due to
its ceiling effect?
A. Buprenorphine
B. Naloxone
C. Clonidine
D. Methadone

Question 23
L. J. is a 55-year-old male who attended a funeral and found himself laughing during the
service, but later that evening he was irritated with himself for what he had done. His
wife said this was abnormal behavior and took him to his doctor to be evaluated. After L.
J.’s MRI was reviewed, he was diagnosed with frontotemporal dementia. Which
medication is recommended to help L. J. with his emotional outbursts? (SSRI)
A. Memantine
B. Escitalopram
C. Donepezil
D. Risperidone

Question 24
A new patient presents to your clinic today. The patient is a 13-year-old boy who
complains that he has no interest in anything. The patient states, “I just want to sleep
more than I normally do, and I don’t care much for playing my video games anymore.”
His mother states he cannot focus on anything for more than a few minutes at a time,
and that he often gets in trouble at school because he cannot sit still. What would you
recommend at this time?
A. Recommend doing a full evaluation to distinguish if this patient is presenting
with ADHD symptoms or depressive symptoms
B. Begin a stimulant at appropriate dose once patient’s weight is known
C. Refer to a behavioral counselor
D. Begin an SSRI at lowest initial dose and provide counseling on the increased
risk of suicide during the first few months of therapy

Question 25
The patient is a 16-year-old girl with a past history of substance use disorder. She has
been known to abuse prescription opioids and smokes one pack of cigarettes every day.
She has been in and out of recovery for the past year. During her last admission into a
recovery center, she was diagnosed with ADHD, which may have contributed to her
addictive personality. She presents to your clinic today to initiate pharmacotherapy for
her new diagnosis. What would you recommend in this patient? Her current weight is 55
kg.
A. Ritalin 10 mg twice daily
B. Focalin 10 mg twice daily
C. Daytrana 30 mg patch worn for 12 hours daily
D. Atomoxetine 60 mg once daily

Question 26
Drug addiction includes many prescription medications and illegal substances. Of the
drugs listed, which ones can be withdrawn abruptly WITHOUT medical intervention to
prevent withdraw seizures? (Amphetamines)
A. Alcohol
B. Adderall
C. Lorazepam
D. Butalbital

Question 27
Which of the following alcohol screening tools lack sensitivity to detect
hazardous/problem drinking?
A. AUDIT
B. AUDIT-C
C.SASQ
D.CAGE

Question 28
T. B. is a 55-year-old male who has diagnosed with type 2 diabetes 10+ years ago. He
has since had complications from the disease and is suffering from severe neuropathy.
On top of that, T. B. is struggling with his mental health and was recently told he could
be depressed but he had refused treatment at that time. Besides getting his blood sugar
under control, what medication(s) can we use that may be useful in helping T. B.?
Nortriptyline
Venlafaxine
Duloxetine
Fluoxetine
A. I, II, and III
B. I and II
C. II and III
D. IV only

Question 29
A 59-year-old male has been admitted to the E. D. due to a methamphetamine
overdose. The patient’s friend reported he ingested up to 2 grams because “he thought
cops were coming to get him.” The patient’s vitals are all within normal limits, except his
blood pressure is 180/110. What is the best recommendation to make at this time?
A. Administer a beta-blocker like labetalol to help bring his blood pressure down
B. Patient’s blood pressure is considered a hypertension urgency, but it is
probably due to the drug overdose. No action is needed at this time until the
drug has cleared his system.
C. Blood pressure is not a concern right now, but supportive therapy should be
provided in the incidence of respiratory depression.
D. Administer an alpha-blocker like phentolamine to help bring his blood pressure
down.

Question 30
Which medication is a selective alpha-adrenergic agonist that works by mimicking
norepinephrine binding in the pre-frontal cortex, which makes it particularly useful in the
treatment of ADHD?
A. Guanfacine ??
B. Modafinil
C. Lisdexamfetamine
D. Bupropion

Question 31
Choose the correct statement regarding an anti-ADHD medication and its respectful
mechanism of action
A. Methylphenidate – blocks reuptake of dopamine in the pre-synaptic neuron and
promotes release of dopamine from their storage sites in the pre-synaptic
neuron
B. Amphetamines – blocks reuptake of norepinephrine and dopamine into
presynaptic neurons
C. Clonidine – blocks reuptake of dopamine in the pre-synaptic neuron and
promotes release of dopamine from their storage sites in the pre-synaptic
neuron
D. Atomoxetine – acts by blocking the norepinephrine pump on the pre-synaptic
membrane
E. Guanfacine – blocks reuptake of norepinephrine and dopamine into presynaptic
neurons (NO)

Question 32
Patient is a 10-year-old female with diagnosed ADHD who was started on Ritalin 5 mg
twice a day over 2 months ago. She is still experiencing the triad of symptoms
associated with ADHD (impaired attention, impulsivity, and excessive motor activity).
Her mother reports that she is now having difficulty in falling asleep since starting the
medication. She has been on no other anti-ADHD medications and the mother reports
full compliance with medication regimen. What is the appropriate recommendation to
make based on this scenario?
A. Recommend psychotherapy in addition to current treatment
B. Switch to low dose Focalin
C. Add Clonidine
D. Switch to low-dose Adderall and titrate as appropriate in addition to
psychotherapy

Question 33
Patient is a 75-year-old female with a confirmed diagnosis of Alzheimer’s Disease. She
is currently on Donepezil 10 mg daily. She is accompanied to your clinic today by her
daughter, who informs you that her mother has recently had an increase in depressive
symptoms. She has no history of mood disorders. She has a history of hypertension
and tonic-clonic seizures, but both are controlled. Assuming this patient will be
thoroughly evaluated for the diagnosis of depression, what would you recommend as
initial therapy?
A. Amitriptyline
B. Doxepin
C. Fluoxetine
D. Bupropion

Question 34
Choose the correct statement regarding medications used for alcoholism
A. Disulfiram: NMDA receptor antagonist & GABAA agonist (NO)
B. Naltrexone: µ-opioid receptor antagonist that reduces the
reinforcement/euphoria produced by alcohol (Maybe)
C. Acamprosate: enhances the effect of the inhibitory neurotransmitter gammaaminobutyric acid on the GABA receptors by binding to a site that is distinct
from the GABA binding site in the central nervous system. (Maybe)
D. Lorazepam: inhibits alcohol dehydrogenase, leading to a buildup of
acetaldehyde

Question 35
Daytrana is the MPH transdermal system of methylphenidate approved for the
treatment of ADHD in children aged 6 years and older. What is the difference in terms of
the metabolism compared to the other formulations in this class?
A. It is mainly metabolized by the enzyme carboxylesterase once absorbed.
B. It does not undergo first-pass metabolism by the enzyme carboxylesterase in
the liver.
C. It can be cut up and sprinkled onto food so it can bypass first-pass metabolism
in the liver.
D. It uses an osmotic releasing oral system technology to slowly deliver the drug
to the enzyme carboxylesterase in order to make the drug last longer.

Question 36
Which of the following drugs is structurally similar to tramadol; thus, its opioid-mediated
analgesia can be reversed by naloxone in mice?
A. Venlafaxine
B. Ketorolac
C. Duloxetine
D. Gabapentin

Question 37
Of the following neurotransmitters, which one(s) are known to be severely disrupted in
the disease Dementia with Lewy Bodies? (dopaminergic and cholinergic)(
Acetylcholine
Glutamate
Dopamine
GABA
Norepinephrine
A. II only
B. III only
C. I and II
D. I and III

Question 38
When can buprenorphine be initiated in a patient who is suffering from an opioid
overdose?
A. As soon as the patient is stabilized
B. It should be administered as soon as you find the patient unconscious
C. Right after naloxone is administered to prevent the patient from going back into
opioid overdose
D. When the patient is experiencing mild-to-moderate symptoms of withdrawal

Question 39
Which features are consistent with delirium?
Acute onset
Gradual onset
Course of disease fluctuates
Course of diseases does not fluctuate
Impaired attention
Normal attention
A. II, IV, and VI
B. I and III
C.II and IV
D .I, III, and V

Question 40
Which medication below should be routine for all suspected cases of alcohol
intoxication and dependence?
A. B vitamin thiamine 100 mg
B. Haloperidol 5 mg
C. Lorazepam 2 mg
D. Acamprosate 666 mg

Question 41
Disulfiram has been proven effective in the treatment of alcoholism, but recently it has
been trialed in the management of cocaine addiction. What is the mechanism of action
that likely helps produce these aversive effects?
A. Inhibition on dopamine beta-hydroxylase
B. Inhibition on aldehyde dehydrogenase
C. Inhibition on alcohol dehydrogenase
D. Inhibition on aldehyde reductase

Question 42
This medication cannot be used for more than 5 days, it is a non-steroidal, antiinflammatory drug, and it is often substituted for morphine due to its rapid onset and
high potency. What is this medication?
A. Naproxen
B. Ketorolac
C. Sulindac
D. Etodolac

Question 43
Which club drug is structurally similar to GABA?
A. 3,4 – methylendedioxy-methamphetamine
B. Ketamine
C. γ-hydroxybutyrate
D. Ecstasy

Question 44
What is the difference between Ritalin and Focalin?
A. Focalin is a D-isomer
B. Ritalin is the D-isomer
C. Focalin is the S-isomer
D. There is no difference other than the formulations involved.

Question 45
Which of the following is the only Black Box Warning associated with the medication
atomoxetine?
A. Increased risk for cardiovascular
events
B. Suicidal ideation
C. Substance abuse potential
D. Slight growth inhibition

Question 46
Disorientation, tremor, hyperactivity, fever, hallucinations, marked wakefulness, and
increased autonomic tone are all features that are consistent with which part of alcohol
withdrawal?
A. Alcohol withdrawal seizures
B. Korsakoff’s Psychosis
C. Wernicke’s encephalopathy
D. Alcohol withdrawal delirium

Question 47
Which neurotransmitters are likely involved in the pathophysiology of withdrawal
seizures?
Serotonin
Endorphins
Glutamate
GABA
Dopamine
A. I and II
B. II and V
C. I and III
D. III and IV

Question 48
FILL IN THE BLANK: ___________ is the main neurotransmitter behind reward systems
in the brain, which usually leads to addiction when altered in any way.
A. Norepinephrine
B. Serotonin
C. Dopamine
D. Acetylcholine

Question 49
Select the correct treatment regarding drugs involved in addiction management and
their corresponding mechanism of action.
A. Benzodiazepines – GABA antagonist
B. Buprenorphine – opioid antagonist
C. Naltrexone – partial opiate agonist
D. Flumazenil – GABA antagonist

Question 50
The experience of pain is ALWAYS subjective
A. True
B. False

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